Patience MANEH TEKWECK
CaHReF 2018, Yaoundé Congres hall, 08 – 11 January 2019 , OAU045
Background: HIV/AIDS remains a public health concern worldwide and Sub Saharan Africa carries a disproportionate burden. People living with HIV/AIDS (PLHA) are at high risk of having sleep disorders and this is associated with physiologic and psychological factors. Sleep disorders are known to negatively influence treatment (HAART) adherence.
Objectif: Determine prevalence of sleep disorders, identify factors associated with sleep disorders among people living with HIV/AIDS and to evaluate its impact on treatment adherence.
Methodology: This was a hospital-based cross-sectional study carried out over a period of 3 months. Participants were selected by consecutive sampling. An interviewer-administered validated questionnaire was used to obtain socio-demographic and clinical data. Self-reported measures of sleep, anxiety, depression and adherence to medication were assessed using Pitsburgh sleep quality index scale (PSQI), Epworth sleepiness scale (ESS), STOPBANG questionnaire, Hospital anxiety and depression scale (HADS) and 8-item Moriskys medication adherence scale (MMAS). Athropometric parameters (weight, height, mid-neck and waist circumferences) were also measured. Data were entered and analysed using Epi info 7. Level of significance was set at p < 0.05.
Results: A total of 525 particpants (mean age 43.5 ±10.0 years, 72.5 % female) were enrolled.This study revealed an overall prevalence of sleep disorders of 21.8%. The median duration of diagnosis of HIV infection was 7 (IQR 0-21) years. Proportion of PLHA with insomnia was 2.9% (PSQI score>5) and daytime sleepiness of 7.8% (ESS>10). According to STOPBANG scale, 11.1% of PLHA had an increased risk of obstructive sleep apnoea. A past history of opportunistic infection was significantly associated with daytime sleepiness (Odds Ratio (OR), 2.41; 95% Confidence Interval (CI), 1.04-5.54), (p=0.03). Also, there was no significant association between sleep disorders and treatment adherence.
Conclusion/Recommandation: Our study revealed that one out of thirty-three persons living with HIV/AIDS suffer from insomnia (PSQI5), one in thirteen from excessive daytime sleepiness (ESS>10) and one in ten have an increased risk of obstructive sleep apnoea. Past history of opportunistic infection was associated with daytime sleepiness and increased waist circumference was significantly associated with OSA. There were no psychosocial consequences of sleep disorders among PLHA and no significant effect of sleep disorders on adherence.
Key Words: sleep disorders, HIV/AIDS, Adherence, HAART